Apparatus for surgically cleansing surfaces.



c. E. KELLS. I APPARATUS FOR SURGICALLY CLEANSING SURFACES.

APPLICATION FILED OCT- 5.1914.

G. E. KELLS.

APPARATUS FOR SURGICALLY CLEANSING SURFACES.

APPLICATlON FILED OCT-5.1914.

2 SHEETSSHEET 2 Patented Sept. 7, 1915.

CHARLES EDMUND KELLS, OF NEW ORLEANS, LOUISIANA.

APPARATUS FOBS'URGICALLY CLEANSING SURFACES.

Specification of Letters Patent.

Patented Sept. 2, 1915.

Application filed October 5, 1914. Serial No. 865,068.

To aZZ whom it may concern Be it known that 1, CHARLES EDMUND KELLs, a citizen of the United States, residing at New Orleans, in the parish of Orleans and State of Louisiana, have in.- vented a new and useful Improvement in Apparatus for Surgically Cleansing Surelevation of the parts shown in Fig. 3 which are immediately to the left of Fig. 4.; Fig. 5 is a section through the sight feed-chamber; Fig. 6 is a section through the upper end of the fluid-receiver; Fig. 7 is a top plan of the fluid-receiver-holder, the point of View being indicated by the line 7 in Fig. 6; Fig. 8 is a section showing the man ner of connecting the operating instrument to the remainder of the apparatus; Fig. 9 is a longitudinal section of the operating instrument.

Referring to drawings, the operating instrument proper consists of an outer tube 10 with a perforated head 11. A partial vacuum is maintained in the tube 10 by the mechanism hereafterto be described. 12 is a fluid-supply pipe which enters the tube 10 near its rear end. and runs down inside the same to a point within the head where it terminates in a diagonal tip 13. In oper ation the cleansing fluid accomplishes at least two functions. During moments when the suction is interrupted the cleansing fluid is permitted to run out through the openings in the head upon the surface to be cleansed and by again setting up the suction it may be immediately picked up before it has hadtime to spread and carry infection from one part of the surface to another. The amount of fluid which is permitted to flow out will depend on the conditions, and the amount of loosening of extraneous matter, whichare required. Furthermore, it is found that the mere suction will not properly pick up heavy and thick fluids,

such as pus, because these thick fluids clog the pipe. Thus, to handle them by suction alone one must employ very heavy suction, much more powerful suction than is good for the tissues which are being operated upon, since heavy suction is likely to' draw the tissues powerfully against the openings of the head. With the present arrangement any heavy fluid which is picked up by the head s lmmediately diluted by the fluid emerging from the tip 13 of the inner pipe and it is thus possible, with very light suction, to handle thick fluids rapidly and efficiently.

The desired suction is maintained by a pump 14 driven by a motor 15. The suction s controlled, in the form of construction lllustrated, by the foot of the operator through the mechanism shown in Figs. 1 and 2. A branch pipe 16 runs from the main suction pipe communicating With the m-take side of the pump, underneath a lever 17 normally held down by the spring 18 so as to compress the pipe 16'. When the parts are in t is position the suction is effective. Whe the rear end of the lever 17 1s ralsed by pressing a button 19 the control pipe 16 is opened to the atmosphere and the effective action of the pump upon the remainder of the apparatus ceases. The suction controlling parts are mounted in a boxlike frame 20 provided with a stirrup 21 so that the operator can move it conveniently from place to place with the foot.

Ainother branch pipe 22 leads from the ma n ln-take pipe of the pump to a gage 23 which indicates to the operator the effective suction.

The in-take pipe of the pump is connected by a pipe 241- with an over-flow reservoir 25 1n which-suctionis maintained. This reseryou, in its preferred form, is a large bottle in the neck of which is cork 26 supplied with a fitting 27 to which the pipe 24 is directly connected, and from which leads a pipe 28 to a slmilar fitting mounted in a cork 29 in the up er end of a receiver 30. The fitting 27 an the fitting in the cork 29 are identical, their construction being best shown in Fig. 6. From this figure it will be seen that the cork is traversed by a shouldered sleeve 31, having a lateral nipple 32 attached toa lateral pipe 33. The sleeve is held in lace by a nut 34 which holds the'cork firmly etween itself and the shoulder on the sleeve 31, said shoulder being indicated by the character 35.

I Through the top of the sleeve extends a pipe i the pipes can 36 operating as an in-take. Thus, suction applied to the lateral pipe will create a partial vacuum in the interior of the vessel closed by the cork which will in turn create suction in the central in-take pipe 36. The pipe 36 is connected by a flexible pipe 37 with the main or outer tube 10 of the instrument, while the end of the intake pipe 12 of the instrument is connected, by a pipe 38 to the sight glass 39, which in turn is connected, by a pipe 40, with a reservoir 4:1. a feed control mechanism being interposed. The two pipes 37 and 38 are made in two sections, short pieces of rigid tube 42 being interposed so that the instrument can conveniently be removed and another substituted, and also so that the efl ective length of be varied at will. The structure of this joint arrangement is shown in Fig. 8. a

The construction of the sight glass 39 is shown in Fig. 5. It consists of an outer body corked at the upper end, a tube 43 entering it through a central opening in the cork. The sight glass, like several other parts of the device, receives its support from a standard 44, a notched bracket e5 receiving the sight glass.

The feed control is shown in Fig. 3. The

, lower end of the reservoir has slipped over it a piece of rubber tubing l6 which receives and holds a shouldered hollow nozzle H. The rubber tube 40 is slipped over the tip of this nozzle. A. hollow cylindrical member 48 is slipped over the tube 40 and has its upper end slitted to grip the lower shou dered end of the nozzle 47. A. set screw 4:91 is provided in the cylindrical part as to compress the rubber tube 40 so as to regulate the feed from the reservoir into the sight glass.

The operation of the device can now be explained, the manipulation of the instrument or tip having been previously set forth. A cleansing, or antiseptic fluid, is placed in the reservoir 41 which, it will be noted, is graduated. The pump is started and the surface to be operated upon is cleansed. If the surface has any considerable amount of fluid upon it, such as blood or pus,the fluid will be first removed. A small amount of the cleansing fluid willthen be permitted to exude upon the surface through the tip, and

will be forthwith sucked up before has had an opportunity to spread into adjacent territory and carry infection from place/t0 place on the surface. In other words, these periods of suction and non-suction will fluid is only on the surface in small quantiflow of the cleansing ties and for short periods, so that the surface is cleansed part by part and without any fluid from place to place upon it. Obviously, the cleansing fluid fol-y low .each. other so closely in practice that the\ ultimately finds its way to the reservoir 30 together with any additions of foreign matter which have been picked up by it. This I6Cl"61 is also graduated, and the operator can tell at any moment by inspecting the reservoir and the receiver how much foreign matter has been added to the cleansing fluid. This point is of great importance when using my present apparatus in lieu of sponges in surgical operations, for which use it is admirably designed. In the use of ordinary sponges a surgeon can only tell how much blood the patient has lost by a very general estimate based on the number of sponges and their appearance; The appearance, however, will vary with the color of the blood, and concededly there is no accuracy whatever in this method of determination. With my present apparatus the difference between the fluid removed from the reservoir and that in the receiver at any given moment indicates absolutely the amount of blood the patient has lost. The overflow reservoir 25 is simply a safety device so that under no possible conditions can the fluid overflow into the pump.

Relative to the general operation of the device, it'w ill be understood that tips or instruments of various sions can be made for various purposes, the present tip being one which has been found advantageous for general use in cleansing surfaces of considerable area. Much smaller tips have been made and found satisfactory in special operations on limited tracts. In

practice it is found that my present device very greatly shortens the duration of surgical operations since the surfaces operated upon can be kept freefrom blood without the use of the usual sponges. The delays consequent upon the use of the sponges, and placing them in position, are thus saved and the surgeon has more ready access to the parts operated upon.

The number of details of construction have not as yet been alluded to, these relating to the sterilization of the parts, and maintaining them sterile in use. The reservoir 4:1 is held by a clamp 50 from which it can be removed, carrying regulating device, sight glass and pipe 38, all of which parts can be sterilized and kept sterile in the usual manner. While there is theoretically no possibility of back-flow, the plan of complete sterilization of all parts now universally practiced in connection with operations has rendered it desirable to sterilize the receiver 30. This stands on a platform 51 and is heldby an open clamp 52.

ized. Tn practice a considerable number of with it the feed l these devices will be employed, and it will be noted that the tip is of such form that it can be conveniently placed in a receptacle, such as a tall glass jar, and kept sealed until desired for use. An instrument bracket 53 is provided at the upper end of the device, this bracket being notched to receive and hold the instrument or tip. The bracket 53 is removed from standard and can be separately sterilized, thereby affording a sterile support for the instrument or tip when not in use. The arrangement, therefore, is such as to meet with all of the requirements of modern hospital practice in the matter of surgical cleanliness.

The present arrangement I have found a convenient one, all the parts being mounted on a common base so that they can be readily moved about. Electric current for running the motor is led in through a socket 54: at the upper end of the standard so that the lead-wire will be overhead and out of the way. The suction control can be operated without inconvenience, although, if desired, other forms of control can be adapted such as, for instance, a hand-control.

I realize that considerable variation is possible in the details of the construction herein shown, and I do not intend to limit myself thereto, except as pointed out in the following claims, in which it is my intention to claim all the novelty inherent in the device as broadly as is permitted by the state of the art.

What I claim as new and desire to secure by Letters Patent:

1. A tubular instrument or tip for surgically cleansing surfaces provided with a reticulated end to be placed adjacent to the surface to be cleansed, means for exerting suction on the interior of the tip to draw fluid through the reticulated end into and through its interior, and means to introduce fluid immediately inside of the tip for the purpose set forth.

2. A tubular instrument or tip for surgically cleansing surfaces provided with a reticulated end to be placed adjacent to the surface to be cleansed, means for exerting suction on the interior of the tip to draw fluid through the reticulated end into and through its interior, and means to introduce fluid immediately inside of the tip for the purpose set forth, and means for interrupt ing the suction to permit the fluid to exude upon the surface.

3. In combination, a tubular instrument or tip, a graduated fluid reservoir, means to conduct fluid to the tip, a graduated receiver, means to withdraw fluid from the tip and conduct the same to the receiver whereby the excess fluid in the receiver over that removed from the reservoir can be determined, and an overflow receiver connected with the first named receiver whereby to prevent the flooding of the suction exerting means by the withdrawn liquid. 7

4. In combination, a reservoir means for regulating the flow therefrom, a tubular tip means for conducting fluid to the interior thereof, a receiver, means connecting the receiver and tip, an over-flow receiver connected to the first named receiver and means for applying suction to the interior of the overflow receiver.

In witness whereof I have hereunto set my hand and aflixed my seal this 12 day of September, 1914:.

- CHAR-LES EDMUNDKELLS. Tn presence of two subscribing witnesses- A. F. MURRAY, W. F. MCCARTHY. 

